Frontiers in Cellular and Infection Microbiology最新文献

{"title":"Whole-genome sequencing reveals transmission pattern and drug resistance of <i>Mycobacterium tuberculosis</i> intra- or inter-hosts.","authors":"Feng Ding, Wanfei Liu, Chi Wu, Wensi Zhang, Shuyan Chen, Wenjie Lai, Jiayao Qu, Qiang Lin, Shuihua Lu, Jiuxin Qu","doi":"10.3389/fcimb.2024.1488547","DOIUrl":"10.3389/fcimb.2024.1488547","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a serious global public health problem. The <i>Mycobacterium tuberculosis</i> (MTB) is responsible for approximately 10 million new TB cases globally each year. This study aimed to investigate transmission pattern and drug resistance of MTB in Shenzhen, China.</p><p><strong>Methods: </strong>A retrospective study on 286 samples from 184 TB patients collected between 2015 and 2018 in Shenzhen Third People's Hospital was conducted using whole-genome sequencing. Drug susceptibility testing (DST) was performed using both phenotypic DST (pDST) and molecular DST (mDST). Sample diversity was evaluated by SNPs and transmission clusters were identified based on SNP differences of 12 or fewer in genetic clusters.</p><p><strong>Results: </strong>Except four samples identified as non-tuberculous mycobacteria, 282 MTB samples (181 patients) underwent mDST, with 244 samples (162 patients) undergoing pDST. The overall multidrug-resistant rate in patients was 22.31% in pDST (12.00% for new patients and 40.82% for retreatment patients) and 34.48% in mDST (20.41% for new patients and 58.21% for retreatment patients). Totally 92 transmission clusters were identified, encompassing 70.21% samples (57.46% patients), with 5 clusters containing samples (15, 5.32%) from different patients (9, 4.97%), indicating recent transmission. The drug-resistant mutations in 36 of 45 transmission clusters (80.00%) were identical in all samples, suggesting the transmission of drug resistance. Patients with multiple samples were categorized into simultaneous sampling (SS) and continuous sampling (CS) groups, revealing significant differences in treatment types, treatment outcomes, residential addresses, and drug resistance types. mDST showed greater accuracy than pDST in SS and CS groups. A novel method based on heterozygous SNPs and two-sample Kolmogorov-Smirnov test were developed and identified 12 (4.26%) samples as mixed infection samples. Six of 12 patients had mixed and pure samples together, and major strains of mixed samples were closer to corresponding pure strains than minor strains.</p><p><strong>Conclusions: </strong>This retrospective study, conducted at the only municipal hospital specializing in infectious diseases in Shenzhen, provides the opportunity to understand drug resistance of TB patients, which mainly are refractory patients. The study revealed transmission patterns of MTB, analyzed mixed infections, and tracked changes in MTB strains during short/long-term treatment.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1488547"},"PeriodicalIF":4.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Borrelia burgdorferi</i> tolerates alteration to P66 porin function in a murine infectivity model.","authors":"Christa H Fierros, Marie-Line Faucillion, Beth L Hahn, Phillip Anderson, Mari Bonde, Julie R Kessler, Matthew C Surdel, Kyler S Crawford, Yan Gao, Jieqing Zhu, Sven Bergström, Jenifer Coburn","doi":"10.3389/fcimb.2024.1528456","DOIUrl":"10.3389/fcimb.2024.1528456","url":null,"abstract":"<p><p><i>Borrelia burgdorferi</i> exists in a complex enzootic life cycle requiring differential gene regulation. P66, a porin and adhesin, is upregulated and essential during mammalian infection, but is not produced or required within the tick vector. We sought to determine whether the porin function of P66 is essential for infection. Vancomycin treatment of <i>B. burgdorferi</i> cultures was used to screen for P66 porin function and found to generate spontaneous mutations in <i>p66</i> (<i>bb0603</i>). Three novel, spontaneous, missense P66 mutants (G175V, T176M, and G584R) were re-created by site-directed mutagenesis in an infectious strain background and tested for infectivity in mice by ID₅₀ experiments. Two of the three mutants retained infectivity comparable to the isogenic control, suggesting that <i>B. burgdorferi</i> can tolerate alteration to P66 porin function during infection. The third mutant exhibited highly attenuated infectivity and produced low levels of P66 protein. Interestingly, four isolates that were recovered for <i>p66</i> sequencing from mouse tissues revealed novel secondary point mutations in genomic <i>p66</i>. However, these secondary mutations did not rescue P66 porin function. New structural modeling of P66 is presented and consistent with these experimental results. This is the first work to assess the contribution of P66 porin function to <i>B. burgdorferi</i> pathogenesis.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1528456"},"PeriodicalIF":4.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143187742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational biology and artificial intelligence in mRNA vaccine design for cancer immunotherapy.","authors":"Saber Imani, Xiaoyan Li, Keyi Chen, Mazaher Maghsoudloo, Parham Jabbarzadeh Kaboli, Mehrdad Hashemi, Saloomeh Khoushab, Xiaoping Li","doi":"10.3389/fcimb.2024.1501010","DOIUrl":"10.3389/fcimb.2024.1501010","url":null,"abstract":"<p><p>Messenger RNA (mRNA) vaccines offer an adaptable and scalable platform for cancer immunotherapy, requiring optimal design to elicit a robust and targeted immune response. Recent advancements in bioinformatics and artificial intelligence (AI) have significantly enhanced the design, prediction, and optimization of mRNA vaccines. This paper reviews technologies that streamline mRNA vaccine development, from genomic sequencing to lipid nanoparticle (LNP) formulation. We discuss how accurate predictions of neoantigen structures guide the design of mRNA sequences that effectively target immune and cancer cells. Furthermore, we examine AI-driven approaches that optimize mRNA-LNP formulations, enhancing delivery and stability. These technological innovations not only improve vaccine design but also enhance pharmacokinetics and pharmacodynamics, offering promising avenues for personalized cancer immunotherapy.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1501010"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of HIV on HPV-related cancers in men who have sex with men: a review.","authors":"Zixuan Zhang, Yuying Xing, Tingdan Gong, Wanlin Li, Siwei Zhang, Lanlan Wei","doi":"10.3389/fcimb.2024.1428491","DOIUrl":"10.3389/fcimb.2024.1428491","url":null,"abstract":"<p><p>Co-infection with human immunodeficiency virus (HIV) significantly increases the incidence of human papillomavirus (HPV) infection and HPV-related cancers among men who have sex with men (MSM). Conversely, HPV infection can also influence HIV acquisition rates. HIV-induced immune suppression may affect chromosomal stability, gene expression, protein function and other molecular components in MSM with HPV-related cancers. Additionally, HIV infection also alters cellular mechanisms by compromising immune responses and epithelial integrity. In this review, we reviewed the influence of HIV on specific HPV-related cancers in MSM, including oropharyngeal squamous cell carcinoma, penile cancer, and anal cancer. We integrated epidemiological data from the past five years and discussed diagnosis and treatment strategies. Overall, our review offers crucial insights into the underlying molecular and cellular mechanisms of these co-infection MSM patients. Our review aims to assist future research in developing effective treatment strategies for MSM with HIV/HPV co-infection.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1428491"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of serotype O3b and high-risk clone ST37 of <i>Klebsiella pneumoniae</i> revealed by comparative genomic analysis.","authors":"Sivaraman Gopalan Krishnan, Sudha Sajeev, Visnuvinayagam Sivam, Raja Swaminathan T, Rakshit Ojha, Bibek Ranjan Shome, Mark Holmes, Thanigaivel Sundaram, Ramesh M D, Saranya Vinayagam, Suseela Meesala, Tabarak Malik, Pavan Kumar Dara","doi":"10.3389/fcimb.2024.1517125","DOIUrl":"10.3389/fcimb.2024.1517125","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological risk factors such as the demography of a place, environment, food, livestock, and companion animals are known sources of <i>Klebsiella pneumoniae</i> infection. Whole-genome sequencing (WGS) has become a powerful tool to complement traditional microbiological characterization of foodborne pathogens. Moreover, <i>K. pneumoniae</i> has several species complexes (KpSC) and is very difficult to differentiate using routine microbiological methods. The present study aims to investigate the prevalence of <i>K. pneumoniae</i> in fish available in the retail market using WGS.</p><p><strong>Methods: </strong>Isolation of <i>K. pneumoniae</i>, identification of <i>K. pneumoniae</i> isolates, and determination of the minimum inhibitory concentration (MIC) were performed. Whole-genome sequencing of <i>K. pneumoniae</i> genomes and phylogenomic analysis were conducted for visual comparison of the genomes. Furthermore, genomes of non-human origin that were submitted from India to the NCBI database were downloaded and included in the comparative analysis.</p><p><strong>Results: </strong>The findings showed that many antibiotic-resistant genes (ARGs) are prominent, including <i>acrD, BaeR, cpxA, mdtB, mdtC, CRP, H-NS, KpnE, KpnF, KpnG, KpnH, acrA, acrB, marA, ramB, oqxA, oqxB, LptD</i>, and <i>emrR</i>. Four fish-sourced isolates had different blaSHV resistance gene variants. The presence of ARGs for aminoglycosides [aac(3)-IId], fluoroquinolones (oqxA, oqxB), and fosfomycin (fosA5, fosA6) in these <i>K. pneumoniae</i> isolates from fish sources was found. One of the CIFT-K6 isolates had the uncommon serotype of <i>K. pneumoniae</i> O3b with the high-risk clone \"ST37.\" The ST515 sequence type was present in two <i>K. pneumoniae</i> isolates (CIFT-K7 and CIFT-K8), but the O3b serotype and ST192 allele type were present in the CIFT-K10 isolate.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this research study represents the first Indian report of <i>K. pneumoniae</i> linked to fish, specifically the high-risk clone 'ST37' and two other STs, 515 and 192. The most common plasmid type detected in all four isolates was IncFIB, and 75% of the isolates were IncFII and IncHI1B. The prevalence of ARGs linked to efflux pump resistance mechanisms is highlighted by the analysis of genome sequence data.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1517125"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SERINC5 counters retroviruses and non-retroviruses.","authors":"Jinghua Yu, Chunyu Liu, Xinglong Qu, Xinglin Gao, Yue Liu","doi":"10.3389/fcimb.2024.1516806","DOIUrl":"10.3389/fcimb.2024.1516806","url":null,"abstract":"<p><p>SERINC5 (serine incorporator 5), a member of the serine incorporator family, has been identified as a retrovirus restriction factor that inhibits the fusion of virions with the plasma membrane, thus blocking the release of the viral core into target cells and subsequently attenuating viral infectivity. Several viruses, such as human immunodeficiency virus (HIV), murine leukemia virus (MLV), and equine infectious anemia virus (EIAV), have evolved mechanisms to antagonize the host protein SERINC5 through HIV Nef, MLV glycosylated Gag, and the EIAV S2 protein. These viral proteins degrade SERINC5 on the cell surface through the endolysosomal system. In addition to its direct antiviral ability, SERINC5 also modulates immunity to inhibit the replication of retroviruses and nonretroviruses. This review summarizes the interaction between SERINC5 and viral replication, providing a promising avenue for fighting viral diseases.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1516806"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The histone methyltransferase DOT1B is dispensable for stage differentiation and macrophage infection of <i>Leishmania mexicana</i>.","authors":"Nicole Eisenhuth, Elisa Theres Rauh, Melina Mitnacht, Andrea Debus, Ulrike Schleicher, Falk Butter, Katerina Pruzinova, Petr Volf, Christian J Janzen","doi":"10.3389/fcimb.2024.1502339","DOIUrl":"10.3389/fcimb.2024.1502339","url":null,"abstract":"<p><p>Conserved histone methyltransferases of the DOT1 family are involved in replication regulation, cell cycle progression, stage differentiation, and gene regulation in trypanosomatids. However, the specific functions of these enzymes depend on the host evasion strategies of the parasites. In this study, we investigated the role of DOT1B in <i>Leishmania mexicana</i>, focusing on life cycle progression and infectivity. In contrast to <i>Trypanosoma brucei</i>, in which DOT1B is essential for the differentiation of mammal-infective bloodstream forms to insect procyclic forms, <i>L. mexicana</i> DOT1B (<i>Lmx</i>DOT1B) is not critical for the differentiation of promastigotes to amastigotes <i>in vitro</i>. Additionally, there are no significant differences in the ability to infect or differentiate in macrophages or sand fly vectors between the <i>Lmx</i>DOT1B-depleted and control strains. These findings highlight the divergence of the function of DOT1B in these related parasites, suggesting genus-specific adaptations in the use of histone modifications for life cycle progression and host adaptation processes.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1502339"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mouse model of immunosuppression facilitates oral <i>Candida albicans</i> biofilms, bacterial dysbiosis and dissemination of infection.","authors":"Raja Veerapandian, Anuja Paudyal, Sarah M Schneider, Sonny T M Lee, Govindsamy Vediyappan","doi":"10.3389/fcimb.2024.1467896","DOIUrl":"10.3389/fcimb.2024.1467896","url":null,"abstract":"<p><p>Opportunistic pathogens are a major threat to people, especially those with impaired immune systems. Two of the most important microbes in this category are the fungus <i>Candida albicans</i> and Gram-positive bacteria of the genus <i>Enterococcus</i>, which share overlapping niches in the oral cavity, gastrointestinal and urogenital tracts. The clinical importance of oral <i>C. albicans</i> biofilm and its interaction with the host under immunosuppressive conditions remains largely understudied. Here, we used a mouse model of oropharyngeal candidiasis (OPC) with cortisone acetate injection on alternate days and a continuous supply of <i>C. albicans</i> in drinking water for three days, resulting in immunosuppression. Results showed abundant growth of resident oral bacteria and a strong <i>C. albicans</i> biofilm on the tongue consisting of hyphae which damaged papillae, the epidermal layer, and invaded tongue tissue with the accumulation of inflammatory cells as demonstrated by Grocott's methenamine silver and hematoxylin and eosin staining, respectively. The dispersed microbes from the oral biofilm colonized the gastrointestinal (GI) tract and damaged its integrity, disseminating microbes to other organs. Although no visible damage was observed in the kidney and liver, except increased lipid vacuoles in the liver cells, <i>C. albicans</i> was found in the liver homogenate. Intriguingly, we found co-occurrence of <i>Enterococcus faecalis</i> in the tongue, liver, and stool of immunosuppressed control and <i>C. albicans</i> infected organs. Targeted 16S rRNA and ITS2 amplicon sequencing of microbes from the fecal samples of mice confirmed the above results in the stool samples and revealed an inverse correlation of beneficial microbes in the dysbiosis condition. Our study shows that mucosal-oral infection of <i>C. albicans</i> under immunosuppressed conditions causes tissue damage and invasion in local and distant organs; the invasion may be aided by the overgrowth of the resident endogenous Enterobacteriaceae and other members, including the opportunistic pathogen <i>Enterococcus faecalis</i>.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1467896"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population genetic analysis of clinical <i>Mycobacterium abscessus</i> complex strains in China.","authors":"Xiangchen Li, Yelei Zhu, Yewei Lu, Kunyang Wu, Yang Che, Xiaomeng Wang, Weixin Wang, Junli Gao, Junshun Gao, Zhengwei Liu, Zhuxian Zhou","doi":"10.3389/fcimb.2024.1496896","DOIUrl":"10.3389/fcimb.2024.1496896","url":null,"abstract":"<p><strong>Background: </strong>To explore the genetic characteristics of the <i>Mycobacterium abscessus</i> complex (MABC) population in China, given its rising clinical importance among nontuberculous mycobacteria.</p><p><strong>Methods: </strong>We conducted population genetic analyses on 360 MABC genomes from China, focusing on core genome multilocus sequence typing (cgMLST), pan-genome characterization, population genetics, and antimicrobial resistance gene profiling.</p><p><strong>Results: </strong>Our analysis identified 273 <i>M. abscessus</i> subsp. <i>abscessus</i> (Mab_A) and 87 <i>M. abscessus</i> subsp. <i>massiliense</i> (Mab_M) isolates, uncovering 68 sequence types (STs), with ST5 being the most common. cgMLST classified 33.3% of isolates into six dominant circulating clones (DCCs) and 49.4% into 59 genomic clusters at a threshold of 25 different alleles, including 18 international clusters linking Chinese isolates with seven other countries. The MABC pan-genome is open, with Mab_A exhibiting greater accessory gene diversity and higher gene turnover compared to Mab_M. Mobile genetic elements (MGEs), such as prophages and genomic islands, were prevalent across all genomes. 139 to 151 virulence factors (VFs) were identified per genome, with distinct accessory VFs in Mab_A and Mab_M affecting immune modulation and metabolism. Resistance gene profiling revealed ubiquitous <i>mtrA</i>, <i>RbpA</i>, and <i>bla</i> _MAB, with Mab_A-specific <i>erm(41)</i> conferring resistance to macrolides and β-lactams. Common <i>rrs</i> and <i>rrl</i> gene mutations indicated widespread resistance to aminoglycosides and macrolides, while <i>gyrA</i> mutations suggested emerging fluoroquinolone resistance. An acquired <i>erm(46)</i> gene, likely obtained via phage-mediated horizontal gene transfer, was detected in one Mab_A strain.</p><p><strong>Conclusion: </strong>This study provides key genetic insights into the dynamics of MABC in China. The widespread distribution of DCCs, high genomic clustering rates, open pan-genome, and distinct resistance patterns between Mab_A and Mab_M, along with MGEs, highlight the need for targeted surveillance and tailored therapies to address emerging challenges in MABC infections.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1496896"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D supplementation during intensive care unit stay is associated with improved outcomes in critically Ill patients with sepsis: a cohort study.","authors":"Caifeng Li, Ke Zhao, Qian Ren, Lin Chen, Ying Zhang, Guolin Wang, Keliang Xie","doi":"10.3389/fcimb.2024.1485554","DOIUrl":"10.3389/fcimb.2024.1485554","url":null,"abstract":"<p><strong>Background: </strong>Patients with vitamin D deficiency are susceptible to increased microbial infection and increased risk of mortality. However, whether vitamin D supplementation would improve their prognosis remains uncertain.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using data from MIMIC-IV database, a publicly available database containing clinical information on patients admitted to the ICU at Beth Israel Deaconess Medical Center (BIDMC) from 2008 to 2019. Adult patients with sepsis were included in the analysis. The exposure factor was vitamin D supplementation during the ICU stay. The primary outcome was 28-day all-cause mortality. Both propensity score matching (PSM) and stepwise regression analyses were employed to adjust for potential confounders.</p><p><strong>Results: </strong>A total of 20230 eligible patients were enrolled in the entire unmatched cohort, and 8710 patients were included in the matched cohort. In PSM analysis, the 28-day all-cause mortality rate was 14.04% (250/1780) in the vitamin D group and 22.31% (1546/6930) in the no vitamin D group. Vitamin D supplementation was associated with decreased 28-day all-cause mortality (HR, 0.56; 95% CI, 0.49-0.64; p < 0.001). Subgroup analyses showed consistent benefits regardless of the baseline vitamin D status (deficiency: HR, 0.70; 95% CI, 0.33-1.50; p = 0.36; insufficiency: HR, 0.10; 95% CI, 0.03-0.34; p < 0.001; sufficiency: HR, 0.33; 95% CI, 0.12-0.88; p = 0.03). Additionally, vitamin D supplementation was associated with decreased ICU mortality (OR, 0.37; 95% CI, 0.29-0.48; p < 0.001) and reduced in-hospital mortality (OR, 0.57; 95% CI, 0.48-0.68; p < 0.001). Sensitivity analysis using the unmatched cohort confirmed these findings (HR, 0.57; 95% CI, 0.43-0.76; p < 0.001).</p><p><strong>Conclusions: </strong>Vitamin D supplementation may reduce mortality in critically ill patients with sepsis. However, further high-quality prospective studies are still needed to validate these findings.</p>","PeriodicalId":12458,"journal":{"name":"Frontiers in Cellular and Infection Microbiology","volume":"14 ","pages":"1485554"},"PeriodicalIF":4.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}